? Question on SLGS

[Molly and Sammy]

I am following SLGS for Sammy, who was diagnosed last September and is on Lantus. Currently 2U 2X day. (see spreadsheet). Human meter. If after a week on a given dose his nadirs are low enough (example 97 on 5/3) to qualify for no increase, do I hold that for another full week before making another decision? I test a lot, and his preshots are typically over 300. I wonde if I have been perhaps fiddling with his dosage more than I should trying to get those 300's down. Lately I feel we might be approaching regulation, and I don't want to mess that up. Thank you!

 

[carfurby (GA)]

If after a week on a given dose his nadirs are low enough (example 97 on 5/3) to qualify for no increase, do I hold that for another full week before making another decision?

Yes, per SLGS you hold the dose for one week and then evaluate, then repeat.

 

[carfurby (GA)]

Unless he earns a reduction.

 

[Sienne and Gabby (GA)]

Molly -

Is there a particular reason you opted for SLGS over TR. You absolutely do test enough to use TR and you're feeding Sammy a low carb canned diet. Given how bouncy Sammy is, there's a chance that TR with it's more aggressive dosing may be better suited for your kitty.

 

[Molly and Sammy]

Unless he earns a reduction.

Thank you!

 

[Molly and Sammy]

Molly -

Is there a particular reason you opted for SLGS over TR. You absolutely do test enough to use TR and you're feeding Sammy a low carb canned diet. Given how bouncy Sammy is, there's a chance that TR with it's more aggressive dosing may be better suited for your kitty.

Thank you! I'm just so scared of a hypo. I'm alone and am not able to drive and getting him to a vet in an emergency would take a lot of doing. And while my vet supports SLGS she does not like TR. That said, I have learned that he responds well to h/c canned food if I need to intervene. He's asymptomatic at this point, and very happy and active. My plan is if I can't get him regulated in another month I will try to try TR. I appreciate your suggestion.

 

[Sienne and Gabby (GA)]

It may help to ease your mind that there’s a difference between low numbers and symptomatic hypoglycemia. Given the logistics of your situation, I think collecting data so you know how Sammy responds to high carb is smart. If you look at Gabby’s spreadsheet or many of the spreadsheets of veteran TR users, you’ll see how we navigated lie numbers with high carb food. It’s nerve wracking at first but it becomes part of your toolkit after a few times.

 

[Molly and Sammy]

It may help to ease your mind that there’s a difference between low numbers and symptomatic hypoglycemia. Given the logistics of your situation, I think collecting data so you know how Sammy responds to high carb is smart. If you look at Gabby’s spreadsheet or many of the spreadsheets of veteran TR users, you’ll see how we navigated lie numbers with high carb food. It’s nerve wracking at first but it becomes part of your toolkit after a few times.

Thanks so much. I really appreciate your advice and example. We've had a few low episodes now, and I'm less squeamish since he responds so well to the h/c food. Thankfully he is always excited to see the gravy. My vet says that numbers under 60 can cause serious damage even without symptoms - do you disagree?

 

[Sienne and Gabby (GA)]

I think it depends on how your vet is assessing numbers. On an AlphaTrack or serum chemistry analyzer that's likely to be correct and vets tend to think in terms of pet specific meters rather than human meters. With TR, for a cat within a year of diagnosis, a dose reduction is given if numbers drop below 50 on a human meter (68 on a pet specific meter). If a cat is a longer term diabetic, reductions are given if the numbers are below 40. TR is based on research conducted at University of Queensland's vet school. If the details of the research weren't safe, the research would never get off the drawing board since the institutional review board would never approve the study. Likewise, a journal would never publish the protocol if it were unsafe especially since it's other vets who review a study for publication.

We've seen cats who have gone into remission and whose numbers, with no insulin on board, have numbers that are in the 40 - 60 range. It's where their BG levels naturally fall. They are fine. They may be more of an exception but it's still an example of how much variability there can be.

I also think it's a matter of how long a cat is staying in low numbers. Is it a matter of a few minutes or a few hours? I'd be nervous if it's the latter.

 

[Molly and Sammy]

I think it depends on how your vet is assessing numbers. On an AlphaTrack or serum chemistry analyzer that's likely to be correct and vets tend to think in terms of pet specific meters rather than human meters. With TR, for a cat within a year of diagnosis, a dose reduction is given if numbers drop below 50 on a human meter (68 on a pet specific meter). If a cat is a longer term diabetic, reductions are given if the numbers are below 40. TR is based on research conducted at University of Queensland's vet school. If the details of the research weren't safe, the research would never get off the drawing board since the institutional review board would never approve the study. Likewise, a journal would never publish the protocol if it were unsafe especially since it's other vets who review a study for publication.

We've seen cats who have gone into remission and whose numbers, with no insulin on board, have numbers that are in the 40 - 60 range. It's where their BG levels naturally fall. They are fine. They may be more of an exception but it's still an example of how much variability there can be.

I also think it's a matter of how long a cat is staying in low numbers. Is it a matter of a few minutes or a few hours? I'd be nervous if it's the latter.

Great info, thank you. I'm going to give TR another look. Meanwhile this morning I got a 240 preshot - yay! Will be here to monitor all morning, hope we can get down to some nice low numbers.